Fibromyalgia Treatment Is a Real Gas

By Pat Anson, PNN Editor

Immersing fibromyalgia patients in high levels of oxygen is more effective at treating their pain and other symptoms than two medications commonly prescribed for the disorder, according to a new study.

Researchers at Tel Aviv University have been studying hyperbaric oxygen therapy (HBOT) for years as a possible treatment for fibromyalgia, a poorly understood condition characterized by widespread body pain, headaches, fatigue, depression and insomnia.  

Hyperbaric medicine is a form of treatment in which patients stay in a pressurized chamber and breathe 100% oxygen to help them heal faster. HBOT has long been used to treat infections, severe burns, carbon monoxide poisoning, and even scuba divers recovering from decompression sickness. The higher air pressure allows lungs to gather more oxygen than they would normally, and promotes the growth of new blood vessels and neurons in the brain.

In a 2015 study, researchers found that HBOT can also induce neuroplasticity in the brain and significantly reduce fibromyalgia pain.

"Until 15 to 20 years ago, there were doctors who believed that it was a psychosomatic illness and recommended that patients with chronic pain seek mental health care¸” said Shai Efrati, MD, of the Sagol Center for Hyperbaric Medicine and Research at Shamir Medical Center. “Today we know that it is a biological illness, which damages the brain's processing of the signals received from the body. When this processing is malfunctioning, you feel pain without any real damage in related locations.”

Efrati and his colleagues recruited 64 adults who suffer from fibromyalgia as a result of a traumatic head injury, and randomly assigned them to two groups.

One group was exposed to 100% pure oxygen in a hyperbaric chamber for 90 minutes, five times a week for three months; while the second group received either pregabalin (Lyrica) or duloxetine (Cymbalta), two FDA-approved medications for fibromyalgia.

The study findings, published in PLOS One, show that HBOT induced significant improvement in pain levels, quality of life, and emotional and social function. The clinical changes were correlated with increased brain activity in the frontal and parietal regions of the brain, which are associated with function and emotional processing.

A HYPERBARIC oxygen CHAMBER. 

"The results were dramatic," said Efrati. "At the end of the treatment, 2 out of 5 patients in the hyperbaric treatment group showed such a significant improvement that they no longer met the criteria for fibromyalgia. In the drug treatment group, this did not happen to any patient.

"In the group that received hyperbaric treatment, you could see the repair of the brain tissue, while in the control group there was only an attempt to relieve the pain -- without treating the damaged tissue -- and of course the medication group experienced the side effects associated with drug treatment.”

Duloxetine is an anti-depressant and pregabalin is an anti-seizure medication. Neither drug was initially developed to treat fibromyalgia, but were later repurposed as pain treatments.

"These drugs are not very effective,” said lead author Jacob Ablin, MD, from the Tel Aviv Sourasky Medical Center. "As a whole, existing treatments are not good enough. It is a chronic disease that significantly affects the quality of life, including young people, and hyperbaric medicine meets an acute need of these patients.”

Ablin says other non-pharmacological treatments are also beneficial for fibromyalgia, such as aerobic activity, hydrotherapy, cognitive-behavioral therapy and Tai Chi. He said quite a few patients request treatment with medical cannabis.

The studies are preliminary, and researchers say more long-term studies are needed to gauge the effects of HBOT after one, two and three years. But they’re encouraged by what they’re finding.

"This is a difference in approach: to cure instead of just treating the symptoms,” says Efrati. “Our goal as doctors is not only to treat the symptoms but to treat as much as possible the source of the problem, thus improving the quality of life of fibromyalgia patients."

The 4 H’s That Can Help Lower Pain Levels

By Barby Ingle, Columnist

One of my goals in this continuing series on alternative pain care is to help people find an effective treatment that they hadn’t considered before. Even we help just one person, it makes it all worthwhile.

I understand that not all treatment options work for everyone. I am also very aware that some patients would rather only do what is “traditional” for their chronic condition. But what if you could get even more relief by adding another therapy or combining multiple treatment options? I believe a treatment I received took me from a wheelchair to walking, but I know that I would have done even better by adding a multi-modal approach to my pain care.

This segment of my series will cover the 4 H’s: hypnotherapy, hyperbaric therapy, holistic living and herbal therapy.

Hypnotherapy

Hypnotherapy is used in chronic pain treatment to create a subconscious change in patients. It will not “cure” a patient of their pain or physical challenges, but it can help form new responses, thoughts, attitudes, and behavior patterns to help cope with constant pain.

Hypnotherapy is a complementary therapy that utilizes suggestive techniques that patients can use to alter their state of consciousness. Using skilled relaxation techniques, the hypnotherapist makes appropriate suggestions to relax our conscious thoughts in order to focus on the subconscious ones.

There are multiple approaches to hypnotherapy, so learning about the different types may be helpful. A few of them include cognitive behavioral therapy, Ericksonian therapy, neuro-linguistic programming, cortical integrative therapy, and past life regression.

There is wide endorsement for hypnotherapies that can be used in habit breaking, stress-related challenges, and treating long-term conditions. We have a hypnotherapist on the iPain board of directors and the National Institute for Health and Care Excellence has also endorsed hypnotherapy for multiple uses.

But there is still a need for more testing and research to provide more concrete evidence that hypnotherapy can help and be used in tandem with traditional treatments.

Not everyone responds to hypnotherapy, as our susceptibility and commitment to the process varies from patient to patient, as do the treatments. It could be a single hypnosis session for issues like smoking cessation or it could be weekly visits for chronic pain.

Costs can vary between $50-150 per session. Some insurance companies will cover hypnotherapy, so it’s a good to check with them before making an appointment. If you want to feel more comfortable about hypnosis before trying it, I suggest that you talk to the therapist first and do some research online. If you need help finding a hypnotherapist in your area, you can start by clicking here.

Hyperbaric Therapy

Hyperbaric oxygen therapy is painless to participate in. It was originally created for deep-sea divers to help them overcome decompression sickness, but has also been used for decades to treat infections, severe burns and carbon monoxide poisoning. More recently it has been found to help people with fibromyalgia and other chronic illnesses.

Many chronic pain patients have trouble with vascular constriction and getting proper oxygen throughout the body, especially to areas that most affected by pain.

Hyperbaric therapy helps improve oxygen levels, which reduces nerve pain, fights infections, and promotes cell growth and wound healing.

Patients undergoing hyperbaric oxygen therapy sit in a pressurized room or tube. The higher air pressure allows lungs to gather more oxygen than they would normally, resulting in 10 to 15 times the normal amount of oxygen being brought to each cell.

This stimulates cell healing and provides vital nutrients to cells that are not functioning correctly. When our cells are not getting the proper amount of oxygen and nutrients, we lose energy, tissue becomes malnourished, and it delays or prevents healing.

Most patients using hyperbaric therapy will require a few rounds of treatment over several weeks to get results. The cost can be quite high, but if you can get your provider to test your vascular constriction with a Doppler Study or another measuring device, your insurance may pay for this treatment.

Holistic Living

Holistic living is more of a lifestyle approach than a treatment, because it is aimed at improving the mind, body and spirit. Once we bring harmony into our lives physically, mentally, spiritually and emotionally, we create a balance that can make the tough times of living with chronic pain more bearable.

The good news is you can start consciously living in a holistic manner at any time. Taking one step at a time is the way to get on the path of self-improvement. Living holistic is about being conscious of all aspects of who you are and the choices you make.  

Holistic living also makes use of massage, acupuncture, acupressure, herbal medicine and other healing options. These are typically out of pocket expenses, so access to them can be limited. But with YouTube, Zubia and other online platforms, it’s easy to find videos – like the one below --to help learn how to live holistically on your own.

Herbal Therapy

Herbal therapy was first introduced to me back in college when I had a cheerleading injury and a friend took me to Chinatown to see a doctor who had been treating her.

I thought it was such a strange experience. He looked at my eyes, my fingers and my tongue. What could he see? What was he looking for? I could hardly understand him, but when he was done, we headed into a room with all kinds of herbs and plants stored in bins.

He walked around the room, chose some items for me, and wrote out on a piece of paper what to do. I took the stuff back to my dorm room and made it into a tea that I drank a little of each day. It was to help with inflammation from my injury.

Some people, including my friend, just ate the herbs and plants. But I didn’t like the taste, so making the tea was easier for me to get it down.

Just because an herb or plant is in its natural state doesn’t make it right for all of us. You should check with an herbalist who has some training in this area. Herbs can interact with some over-the-counter and prescription medications. And be sure to tell your healthcare providers about any herbal medications you are taking.

This month’s spotlight on H’s that can help with pain care are meant to be idea starters. As always, I look forward to hearing from those of you who have tired any of these modalities and whether it improved your general health and to chronic pain specifically.

Barby Ingle lives with reflex sympathetic dystrophy (RSD), migralepsy and endometriosis. Barby is a chronic pain educator, patient advocate, and president of the International Pain Foundation. She is also a motivational speaker and best-selling author on pain topics.

More information about Barby can be found at her website. 

The information in this column should not be considered as professional medical advice, diagnosis or treatment. It is for informational purposes only and represents the author’s opinions alone. It does not inherently express or reflect the views, opinions and/or positions of Pain News Network.